K193 – Family psychotherapy - in-patients (two or more members)
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Family psychotherapy is a form of treatment for mental illness, behavioural maladaptations, and/or other problems that are assumed to be of an emotional nature. It is rendered to an in-patient in the presence of one or more members of the patient's household. The physician deliberately establishes a professional relationship with the patient with the purpose of removing, modifying or retarding existing symptoms, or attenuating or reversing disturbed patterns of behaviour, and of promoting positive personality growth and development. The service is claimed against the patient's health number and diagnosis.
When to Use
- Use K193 when conducting a formal psychotherapy session for an admitted patient involving at least one other household member to address emotional or behavioral maladaptations.
- Select K193 over individual psychotherapy codes like K191 when the clinical focus requires the presence and active participation of family members to modify the patient's existing symptoms.
Common Pitfalls
- Claiming K193 on the same day as A191, A192, A197, or A198 will result in an automatic rejection as these codes are mutually exclusive for the same patient.
- Failure to explicitly record the exact start and end times in the patient's chart is the most frequent cause of clawbacks during OHIP audits.
- Billing K193 for a routine family meeting or status update that lacks the therapeutic intent of modifying psychiatric symptoms or behavior patterns.
Billing Tips
- Ensure the chart note clearly documents the therapeutic goals and the specific contribution of the household members present to justify the family-based nature of the service.
- Since K193 is billed in half-hour units, ensure your start and end times clearly reflect the duration of the session to support the number of units claimed.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Procedure
Psychotherapy, Psychiatric and Counselling Services
The physician must record on the patient's permanent medical record or chart the time when the insured service started and ended. If the patient's permanent medical record or chart does not include this required information, the service is not eligible for payment.
For conditions and definitions - see General Preamble to .
For electroconvulsive therapy fees, see Diagnostic and Therapeutic Procedures.
Unit means ½ hour or major part thereof - see General Preamble , for definitions and time-keeping requirements.
Family psychotherapy is claimed against the patient's health number and diagnosis.
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